Ergotism
Background
- Long term effects of ergotamine usage or ergot poisoning
- Coadministration of ergotamine medication with triptan or certain antibiotics
- Increase in serotonin activity
- α-adrenergic agonist activity peripherally
Clinical Features
- Usage of ergotamines such as dihydroergotamine (DHE) and methylergometrine (Methergine)
- Miosis
- Burning sensation in extremities
- Cerebrovascular ischemia
- Seizures
- Cardiac ischemia
- GI disturbances
- Peripheral ischemia
Workup
Management
- Intake within 2 hours
- Considered activated charcoal
- Consider definitive airway
- Mild ergotism
- Severe Peripheral Vasoconstriction or Ischemia
- Vasodilators - nitroprusside, nitroglycerine
- Consider corticosteroids
- Consider heparinization
Disposition
- Consider observation for mild ergotism
- Admission for severe ergotism
External Links
References
Goldfrank"s Toxicologic Emergencies, 9th Ed. Pgs 705-706, 763-769, and 1060-1064.
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